At present, the optimal therapeutic approach for the treatment of platinum‑resistant recurrent ovarian cancer remains to be fully elucidated. The present systematic review and network meta‑analysis aimed to elucidate the relative efficacy and safety of apatinib, administered either as monotherapy or in conjunction with chemotherapy, compared with chemotherapy alone, for the treatment of platinum‑resistant recurrent ovarian cancer. The PubMed, Embase and Wanfang Data electronic databases were searched, where the search spanned from the conception of the databases until April 2023. A quality evaluation was conducted and R software was used for network meta‑analysis. Following inclusion and exclusion criteria screening, the present analysis included 17 clinical trials, combining data from 1,228 patients with platinum‑resistant recurrent ovarian cancer categorized into the following three treatment cohorts: i) 555 patients who received apatinib plus chemotherapy; ii) 229 patients who received apatinib alone; and iii) 444 patients who underwent conventional chemotherapy. Results of the present study demonstrated that the co‑administration of apatinib with either tegiol [odds ratio (OR), 2.54; 95% CI, 1.06‑6.11] or etoposide (OR, 2.12; 95% CI, 1.20‑3.74) significantly improved the objective response rate (ORR) compared with that following apatinib monotherapy. By contrast, gemcitabine monotherapy resulted in inferior ORR efficacy compared with that following apatinib (OR, 0.47; 95% CI, 0.23‑0.95). In addition, combinations of apatinib with etoposide (OR, 1.32; 95% CI, 1.06‑1.64) or paclitaxel (OR, 1.52; 95% CI, 1.04‑2.23) demonstrated a significantly improved disease control rates (DCR) compared with those following apatinib alone. According to the area under the cumulative ranking analysis, apatinib and paclitaxel in combination was the most efficacious treatment modality in terms of DCR. In terms of safety, the incidence of adverse events, such as hand‑foot syndrome [relative risk (RR), 4.23; 95% CI, 1.80‑9.95] and hypertension (RR, 4.80; 95% CI, 1.53‑15.05), was found to be significantly higher in patients treated with apatinib‑containing therapies, compared with those treated with chemotherapy alone. Consequently, the present meta‑analysis highlighted the potential of apatinib, particularly in combination with chemotherapy, as a therapeutic strategy for patients with platinum‑resistant recurrent ovarian cancer.

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